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Tilting the Ethical Lens: Shame, Disgust, and the Body in Question

Published online by Cambridge University Press:  11 March 2020

Abstract

Cheryl Chase has argued that “the problem” of intersex is one of “stigma and trauma, not gender,” as those focused on medical management would have it. Despite frequent references to shame in the critical literature, there has been surprisingly little analysis of shame, or of the disgust that provokes it. This paper investigates the function of disgust in the medical management of intersex and seeks to understand the consequences—material and moral—with respect to the shame it provokes.

Conventional ethical approaches may not provide quite the right tools to consider this affective dimension of the medical management of intersex, but we find in Nietzsche's Genealogy of Morality a framework that allows us a profound appreciation of its moral significance (Nietzsche 1887/1998). Understanding doctors' disgust—and the disgust that they promote in parents of those born with atypical anatomies—as a contemporary expression of ressentiment directs us to not focus on the bodies of those born with intersex conditions, which have been the privileged objects of attention both in medical practice and in criticisms of it, but moves us to consider instead the bodies of those whose responses constitute the motivating force for normalizing practices in the first place.

Type
Confronting Dis-Abling Norms
Copyright
Copyright © 2011 by Hypatia, Inc.

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References

Asch, Adrienne. 2006. Appearance‐altering surgery, children's sense of self, and parental love. In Surgically shaping children: Technology, ethics, and the pursuit of normality, ed. Parens, Erik. Baltimore, Md.: Johns Hopkins University Press.Google Scholar
BBC. 2001. Intersex conditions. Radio broadcast, December 11. http://www.bbc.co.uk/radio4/womanshour/10_12_01/tuesday/info1.shtml (accessed January 21, 2011).Google Scholar
Beauchamp, Tom L., and Childress, James F. 2001. Principles of biomedical ethics. 5th ed. New York: Oxford University Press.Google Scholar
Biddle, Jennifer. 1997. Shame. Australian Feminist Studies 12 (26): 227–39.10.1080/08164649.1997.9994862CrossRefGoogle Scholar
Chase, Cheryl. 1999. Surgical progress is not the answer to intersexuality. In Intersex in the age of ethics, ed. Dreger, Alice Domurat. Hagerstown, Md.: University Publishing Group.Google Scholar
Chase, Cheryl. 2003. What is the agenda of the intersex patient advocacy movement? The Endocrinologist 13 (3): 240–42.10.1097/01.ten.0000081687.21823.d4CrossRefGoogle Scholar
Consortium on the Management of DSDs. 2006. Clinical guidelines for the management of disorders of sex development in childhood. Rohnert Park, Calif.: Intersex Society of North America.Google Scholar
Diprose, Rosalyn. 2002. Corporeal generosity: On giving with Nietzsche, Merleau‐Ponty, and Levinas. Albany, N.Y.: State University of New York Press.Google Scholar
Dreger, Alice Domurat. 1998. “Ambiguous sex”—or ambivalent medicine? Hastings Center Report 28 (3): 2435.10.2307/3528648CrossRefGoogle ScholarPubMed
Dreger, Alice Domurat. 1999. A history of intersex: From the age of gonads to the age of consent. In Intersex in the age of ethics, ed. Dreger, Alice Domurat. Hagerstown, Md.: University Publishing Group.Google Scholar
Dreger, Alice Domurat. 2000. Jarring bodies: Thoughts on the display of unusual anatomies. Perspectives in Biology and Medicine 43 (2): 151–72.10.1353/pbm.2000.0002CrossRefGoogle ScholarPubMed
Dreger, Alice Domurat. 2002. Intersex. In FatherMag.com, July 23. http://www.fathermag.com/206/intersex/ (accessed March 14, 2010).Google Scholar
Dreger, Alice Domurat. 2006. What to expect when you have the child you weren't expecting. In Surgically shaping children: Technology, ethics, and the pursuit of normality, ed. Parens, Erik. Baltimore, Md.: Johns Hopkins University Press.Google Scholar
Dreger, A.D., Chase, C., Sousa, A., Gruppuso, P.A., and Frader, J. 2005. Changing the nomenclature/taxonomy for intersex: A scientific and clinical rationale. Journal of Pediatric Endocrinology and Metabolism 18 (8): 729–33.10.1515/JPEM.2005.18.8.729CrossRefGoogle ScholarPubMed
Eugster, Erica A. 2004. Reality vs. recommendations in the care of infants with intersex conditions. Archives of Pediatric Medicine 158 (5): 428–29.CrossRefGoogle ScholarPubMed
Feder, Ellen, and Karkazis, Katrina. 2008. What's in a name?: The controversy over ‘Disorders of Sex Development’.” Hastings Center Report 38 (5): 3336.CrossRefGoogle Scholar
Frader, J., Alderson, P., Asch, A., Aspinall, C., Davis, D., Dreger, A., Edwards, J., Feder, E.K., Frank, A., Hedley, L.A., Kittay, E., Marsh, J., Miller, P.S., Mouradian, W., Nelson, H., and Parens, E. 2004. Health care professionals and intersex conditions. Archives of Pediatric Medicine 158 (5): 426–28.10.1001/archpedi.158.5.426CrossRefGoogle ScholarPubMed
Hawbecker, Hale. 1999. Who did this to you? In Intersex in the age of ethics, ed. Dreger, Alice Domurat. Hagerstown, Md.: University Publishing Group.Google Scholar
Howe, Edmund G. 1999. Intersexuality: What should care providers do now? In Intersex in the age of ethics, ed. Dreger, Alice Domurat. Hagerstown, Md.: University Publishing Group.Google Scholar
Hughes, I.A., Houk, C., Ahmed, S.F., and Lee, P.A., Lawson Wilkins Pediatric Endocrine Society (LWPES)/European Society for Paediatric Endocrinology (ESPE) Consensus Group 2006. Consensus statement on management of intersex disorders. Journal of Pediatric Urology 2:148–62.10.1016/j.jpurol.2006.03.004CrossRefGoogle ScholarPubMed
Jonsen, Albert. 2003. The birth of bioethics. New York: Oxford University Press.Google Scholar
Karkazis, Katrina. 2005. Beyond treatment: Broadening debates over genital surgery for intersex infants. American Psychological Association Annual Meeting, Washington, D.C. August 18, 2005.Google Scholar
Karkazis, Katrina. 2008. Fixing sex: Intersex, medical authority, and lived experience. Durham, N.C.: Duke University Press.10.1215/9780822389217CrossRefGoogle Scholar
Kessler, Suzanne J. 1990. The medical construction of gender: Case management of intersexed infants. Signs: Journal of Women in Culture and Society 15 (1): 326.10.1086/494643CrossRefGoogle Scholar
Kessler, Suzanne J. 1998. Lessons from the intersexed. New Brunswick, N.J.: Rutgers University Press.Google Scholar
Kipnis, Kenneth, and Diamond, Milton. 1999. Pediatric ethics and the surgical assignment of sex. In Ethics in the age of intersex, ed. Dreger, Alice Domurat. Hagerstown, Md.: University Publishing Group.Google Scholar
Kittay, Eva Feder. 2006. Thoughts on the desire for normality. In Surgically shaping children: Technology, ethics, and the pursuit of normality, ed. Parens, Erik. Baltimore: Johns Hopkins University Press.Google Scholar
McCumber, John. 2001. Time in the ditch: American philosophy and the McCarthy era. Chicago: Northwestern University Press.Google Scholar
Minto, Catherine L., Liao, Lih‐Mei, Woodhouse, Christopher R.J., Ransley, Philip G., and Creighton, Sarah M. 2003. The effects of clitoral surgery on sexual outcome in individuals who have intersex conditions with ambiguous genitalia: A cross‐sectional study. Lancet 361 (9365): 1252–57.10.1016/S0140-6736(03)12980-7CrossRefGoogle ScholarPubMed
Money, John. 1952/1968. Hermaphroditism: An inquiry into the nature of a human paradox. PhD diss., Harvard University.Google Scholar
Money, John. 1955. Hermaphroditism, gender, and precocity in hyper‐adrenocorticism: Psychologic findings. Bulletin of the Johns Hopkins Hospital 96 (6): 253–64.Google Scholar
Money, John, and Ehrhardt, Anke A. 1982. Man and woman, boy and girl. Baltimore: Johns Hopkins University Press.Google Scholar
Moreno, Angela. 1999. In Amerika they call us hermaphrodites. In Intersex in the age of ethics, ed. Dreger, Alice Domurat. Hagerstown, Md.: University Publishing Group.Google Scholar
Morris, Sherri G. 2006. Twisted lies: My journey in an imperfect body. In Surgically shaping children: Technology, ethics, and the pursuit of normality, ed. Parens, Erik. Baltimore, Md.: Johns Hopkins University Press.Google Scholar
Nicholson, Sven. 1999. Take charge! A guide to home auto‐catheterization. In Intersex in the Age of Ethics, ed. Dreger, Alice Domurat. Hagerstown, Md.: University Publishing Group.Google Scholar
Nietzsche, Friedrich. 1872/1967. Birth of tragedy and the case of Wagner. Trans. Walter Kaufmann. New York: Vintage Books.Google Scholar
Nietzsche, Friedrich. 1887/1974. The gay science. Trans. Walter Kaufmann. New York: Vintage Books.Google Scholar
Nietzsche, Friedrich. 1887/1998. On the genealogy of morality. Trans. Maudemarie Clark and Alan J. Swensen. Indianapolis, Ind.: Hackett Publishing.Google Scholar
Nietzsche, Friedrich. 1889/2009. Twilight of the idols: Or how to philosophize with a hammer. Trans. Duncan Large. New York: Oxford University Press.Google Scholar
Parens, Erik. 2006. Introduction: Thinking about surgically shaping children. In Surgically shaping children: Technology, ethics, and the pursuit of normality, ed. Parens, Erik. Baltimore: Johns Hopkins University Press.Google Scholar
Planas, Gabriela. 2006. “Filiación del sordo.”Pagina 12. http://www.pagina12.com.ar/diario/psicologia/9‐75122‐2006‐11‐01.html (accessed March 14, 2010).Google Scholar
Preves, Sharon. 2003. Intersex and identity: The contested self. New Brunswick, N.J.: Rutgers University Press.Google Scholar
Probyn, Elspeth. 2005. Blush: Faces of shame. Minneapolis: University of Minnesota Press.Google Scholar
Sedgwick, Eve Kosofsky, and Frank, Adam, eds. 1995. Shame and its sisters: A Silvan Tomkins reader. Durham, N.C.: Duke University Press.Google Scholar
Systma, Sharon. 2002. Surgical treatment of intersexuality: Business as usual? Dialogues in Pediatric Urology 25 (6): 57.Google Scholar
Walcutt, Heidi. 1999. Time for a change. In Intersex in the age of ethics, ed. Dreger, Alice Domurat. Hagerstown, Md.: University Publishing Group.Google Scholar
Warne, Garry, Grover, S., Jutson, J., Sinclair, A., Metcalf, S., Northam, E., Freeman, J., and Murdoch Children's Research Institute Sex Study Group. 2005. A long‐term outcome study of intersex conditions. Journal of Pediatric Endocrinology and Metabolism 18 (6): 555–67.10.1515/JPEM.2005.18.6.555CrossRefGoogle ScholarPubMed
Weiss, Gail. 1999. Body images: Embodiment as intercorporeality. New York: Routledge.Google Scholar